I just read about this in the new Midwifery Today E-Newsletter. The American Academy of Family Physicians has issued Trial of Labor after Caesarean guidelines that are significantly different from (and more positive than) ACOG's VBAC policy.
As Midwifery Today sums up:
Hope it helps!
As Midwifery Today sums up:
Quote:
| Some of the most notable highlights are: "TOLAC [Trial of Labor After Caesarean] should not be restricted only to facilities with available surgical teams present throughout labor since there is no evidence that these additional resources result in improved outcomes." "Our recommendation significantly differs from current ACOG policy because we could find no evidence to support a different level of care for TOLAC patients. Without good quality evidence, we believe that different levels of resources cannot be advocated because their potential for unintended harms cannot be evaluated against their purported benefits." "…the ACOG policy suggests that one rare obstetrical catastrophe (e.g., uterine rupture) merits a level of resource that has not been recommended for other rare obstetrical catastrophes (e.g., shoulder dystocia, abruptio placenta, cord prolapse) that may actually be more common." "…current risk management policies across the United States restricting a TOLAC appear to be based on malpractice concerns rather than on available statistical and scientific evidence." |
Hope it helps!
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